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Changes in pro-inflammatory cytokines and media and peptide hormones during multiple organ dysfunction syndrome following acute abdominal diseases
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- Author:
- No author available
- Journal Title:
- CHINESE CRITICAL CARE MEDICINE
- Issue:
- 1
- DOI:
- 10.3760/j.issn:1003-0603.2003.01.005
- Key Word:
- 多器官功能障碍综合征;急腹症;细胞因子;炎症介质;肽类激素
Abstract： 目的:探讨细胞因子及其他炎症介质与肽类激素在急腹症所致多器官功能障碍综合征(MODS)中的作用.方法:动态观察19例MODS患者血浆肿瘤坏死因子-α(TNF-α)、白介素6 (IL6)、血栓素B2(TXB2)、6-酮-前列腺素F1α(6-keto-PGF1α)、内毒素、内皮素-1(ET-1)、降钙素基因相关肽(CGRP)、P物质(SP)及血清脂质过氧化物(LPO)和一氧化氮(NO)水平.结果:MODS患者的TNF-α和IL-6均显著增高;入院当天未治疗者IL-6高于经内镜逆行胆管引流(ERBD)或激素等处理者,重症胆管炎高于重症胰腺炎,并发中毒性休克者高达24 000 ng/L.早期MODS患者的TNF-α和IL-6均显著高于全身炎症反应综合征(SIRS)者;MODS者的内毒素及LPO均显著升高;MODS急症住院者NO升高,某些重症胰腺炎、肝癌及高龄肝脓肿长期发热者NO降低;TXB2和6-keto-PGF1α先升后降;ET-1和CGRP早期明显增高;SP于入院当天达峰值.结论:急腹症患者IL-6持续高于300 ng/L,提示MODS时IL-6和TNF-α可区别全身炎症反应程度;NO存在升高和降低两种情况;ET-1、CGRP、TXB2、6keto-PGF1α、内毒素和LPO增高并促进MODS的形成与发展.
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